Practice Guidelines Grading Systems

Instituto Tecnologico y de Estudios Superiores de Monterey

Status: Completed

Conditions: Decision Making

Treatments: Other: Graded Clinical Recommendation

Study type: Interventional

Funder types: Other

Identifiers

NCT00940290

CMBE-ITESM-1

Details and patient eligibility

About

Clinical practice guidelines (CPG) are systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances. They are developed to give a recommendation based on the best evidence available. Through a randomized trial, the investigators intend to provide information about which of the four grading systems most used today to grade evidence and recommendations in CPGs, could change physician´s behavior towards a common clinical situation in daily practice.

Full description

Clinical practice guidelines (CPG) are used by professional and consumer organizations who are demanding more rigorous processes to ensure that health decisions are well informed by the best available research evidence. More than 60 different grading systems are used today to grade evidence and recommendations in CPGs. The investigators aimed to provide information about which of the four most common grading systems used today (GRADE, SIGN, NICE and CEBM-Oxford) could change physician´s behavior when reading a clinical recommendation in a CPG. The investigators will randomize 216 pediatricians and pediatricians in training into four groups (one for each grading system) to read a clinical case and to make a decision before reading the CPG statement graded with any of the four grading systems. After that they will re-consider their answer and post a new one based on the graded recommendation. The investigators will measure change in their decision and among groups.

Enrollment: 216 patients

Sex: All

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Pediatricians and residents in pediatrics

Exclusion criteria

• Less than six months in clinical practice

Trial design

216 participants in 4 patient groups

GRADE system

Other group

Description:

A clinical recommendation built and graded with the GRADE working group system

Treatment:

Other: Graded Clinical Recommendation

SIGN grading system

Other group

Description:

A clinical recommendation built and graded with the Scottish Intercollegiate Guidelines Network system

Treatment:

Other: Graded Clinical Recommendation

NICE grading system

Other group

Description:

A clinical recommendation built and graded with National Institute of Clinical Excellence grading system

Treatment:

Other: Graded Clinical Recommendation

CEBM-Oxford

Other group

Description:

A clinical recommendation built and graded with the Centre for Evidence-Based Medicine grading system

Treatment:

Other: Graded Clinical Recommendation